Abstract
Introduction
Phospholipids are possible favorable agents for colorectal cancer (CRC). Choline has been inversely related to CRC risk but findings are inconsistent. We assessed the effect of dietary sphingomyelin (SM) choline moiety and total choline intake on risk of CRC.
Method
This analysis is based on a multicenter case–control study conducted between 1992 and 1996 in Italy. A total of 6107 subjects were enrolled, including 1225 colon cancer cases, 728 rectal cancer cases and 4154 hospital-based controls. We applied data on the composition of foods in terms of SM choline moiety and choline intake on dietary information collected through a validated food-frequency questionnaire. Odds ratio (OR) for energy-adjusted tertiles of SM choline moiety and choline were estimated through logistic regression models adjusted for sex, age, center, education, alcohol consumption, body mass index, family history of CRC, and physical activity.
Results
Choline was inversely related to CRC risk (OR for the highest versus the lowest tertile: 0.85; 95% confidence interval [CI]: 0.73–0.99), with a significant trend in risk. The OR for an increment of one standard deviation of energy-adjusted choline intake was 0.93 (95% CI: 0.88–0.98). The association was consistent in colon and rectal cancer and also across colon subsites. SM choline moiety was not associated with CRC risk (OR for the highest versus the lowest tertile: 0.96, 95% CI 0.84–1.11).
Conclusion
This study shows an inverse association between choline intake and CRC but not with SM choline moiety.
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Data availability
Data are available upon reasonable request from the corresponding author.
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Acknowledgements
The authors would like to thank Dr. Alfred H. Merrill Jr for his expert advice during the initial conceptualization of the study.
Funding
This work was supported by the Italian Foundation for Cancer Research (AIRC).
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MR and PB conceived the study; DS, EN, AG, AC, and CLV collected the original data; MR, FF, and MP developed the assessment of exposure, with input from YH and CL; MR analyzed the data, with input from MK, CLV, CP and PB; MR, MK and GC drafted the manuscript, with input from YH, CL, CLV and PB; all authors reviewed and approved the final version of the manuscript.
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The study protocol was submitted to the Board of Ethics of the participating hospitals and received the approval required at the time of data collection. The Ethics Committees of the Hospital “Niguarda Ca’ Granda”, Milan, provided the study approval (1125/194). Informed consent was obtained from all individual participants included in the study. This study was performed in line with the principles of the Declaration of Helsinki.
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Rossi, M., Khalifeh, M., Fiori, F. et al. Dietary choline and sphingomyelin choline moiety intake and risk of colorectal cancer: a case-control study. Eur J Clin Nutr 77, 905–910 (2023). https://doi.org/10.1038/s41430-023-01298-4
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DOI: https://doi.org/10.1038/s41430-023-01298-4
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